Anticholinergic Agents Flashcards

1
Q

What two groups exist as anticholinergics?

A
1. Muscarinic antagonists
aka Parasympatholytic or antimuscarinic
Block effects of parasymp.
drugs-Atropine, scopolamine
2. Nicotninc antagonists
Ganglionic blocker (autonomic NS)
Neuromuscular blockers (NMJ)
drugs-tetraethylammonium, tubocurarine, succinylcholine
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2
Q

What is a class drug example of a muscarine antagonist?

A

Atropine

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3
Q

What effects do anticholinergics have on the CNS?

A

Atropine has minimal effect, scolpalamine is it’s cousin and is used to tx motion sickness, and Parkinson’s (Benztropine)

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4
Q

What effect can toxicity of Scopalamine have on the CNS?

A

excitation, hallucinations, agitation, coma

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5
Q

What is the effect of anticholinergics on the eye?

A

mydriasis, loss of accommodation (cycloplegia)

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6
Q

What effect do anticholinergics have on the CV system?

A
Low dose (0.5-5mg)-blocks M1 and M2 receptors therefore taking away the breaks on M2 and results in Increased BP (because M3 still exists)
High Dose (>10mg) total conduction block-death
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7
Q

What effect do anticholinergics have on the resp. system

A

Bronchodilation, decreased mucus production-tx. for COPD and Asthma

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8
Q

What effect do anticholinergics have on the GI system

A

Decreased motility, decreased peristalsis, tx. for diarrhea (lomotil)

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9
Q

What effect do anticholinergics have on the GU system

A

Decrease ability to void-tx for spasms and inflammatory disorders. Contraindicated for pt’s with BPH

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10
Q

What effect do anticholinergics have on the secretory glands?

A

not always effective because eccrine glands are more sensitive than apocrine glands-but can be used to tx hyperhydrosis.

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11
Q

Name the types of receptors that bind acetylcholine

A

Muscarinic and nicotinic

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12
Q

Where are cholinergic receptors found in the auto. NS

A

Postgang parasymp. and ganglionic level in para and sympathetic sides of autonomic NS

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13
Q

What type of neurons release norepinephrine

A

Adrenergic

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14
Q

A muscarinic agonist causes what effect on the eye?

A

Constriction

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15
Q

A muscarinic agonist causes what effect on res.

A

bronchoconstriction

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16
Q

A msucarinic agonist causes what effect on the CV

A

Decreases HR

17
Q

A muscarinic agonist causes what effect on GU

A

stimulates voiding

18
Q

A muscarinic agonist causes what effect on GI

A

increases motility

19
Q

What effect would muscarinic agonist have on the sympathetic portion of the autonomic nervous system?

A

no effect!

20
Q

What is the name of the enzyme that metabolized acetylcholine?

21
Q

Why do organophosphates inhibit acetylcholinesterase for so long

A

Covalent bond

22
Q

What effect does nicotine have on toxic concentrations in humans

A

Death, seizures, coma, resp. arrest

23
Q
What effect do anticholinergics have on the 
Eye
Resp 
GI 
GU
CV
A
Eye - Belladonna
Resp - Bronchodilation
GI - Decreased motility
GU - Decreased void
CV-Low-decreases HR (M1 blocks), Med-increases (M2 and M1 blocks) High-blocks everything
24
Q

Therapeutic uses of anticholinergics

A

Tx:

Diarrhea, Urinary spasms, asthma, COPD

25
What types of pts might anticholinergics be contraindicated
Glaucoma, BPH
26
Mech action of ganglionic blocking agent
Binds to Nicotinic receptors on para and symp. side of ANS
27
What is difference between non-depol and depol. muscular blocker
non-depol: Strictly antagonist | Depol: super agonist-stimulates and causes too much action takes away the brakes
28
``` Classify as non-depol and deploy Tubercurarine Atracurium Succinylcholine rocuronium coxycurrium veucronium ```
All are non-depolarizing except succinlycholine
29
When would someone use a neuromuscular blocking agent
surgery, ICU, mechanical ventillation